Sierra Tucson residency opportunity exposes psychiatry students to integrated, holistic care

A renewed rotation partnership between the University of Arizona (UofA) Department of Psychiatry and the nationally known Arizona addiction treatment facility Sierra Tucson will allow psychiatric residency students to work with Sierra Tucson patients and staff for up to two months at a time.

According to Aimee Kaempf, MD, assistant professor of psychiatry and director of the Psychiatry Residency Training program at the UofA College of Medicine at South Campus, UofA psychiatry residents have been rotating at Sierra Tucson on and off for more than 10 years. In the past, two-month rotations at Sierra Tucson were a requirement for senior UofA residents.

In more recent years, it has become an elective rotation, which didn’t cultivate as much student participation. The goal under newly-appointed medical director Michael Genovese, MD, is to re-establish Sierra Tucson as a solid site for residency training and allow  for a more  robust experience for students.

Genovese says that the Sierra Tucson staff has become more engaged with treatment team planning and with teaching with the presence of the residents.

“To me, having education in any healthcare system infuses it with enthusiasm. It forces the doctors and the nurses to stay on their game and stay up to speed because they’re now responsible for teaching the people who will be the attendings of tomorrow,” says Genovese. “Just by the nature of the resident being there, patients are getting more care than they otherwise would. And while residents are still learning, they already have a good knowledge base; they bring something to the table in terms of their font of knowledge, as well as their excitement about learning and treating patients.”  

A different sort of learning experience

Students from the university’s south campus and university campus psychiatry residency training programs currently have access to several rotation sites, says Kaempf, including the South Campus Hospital, University of Arizona Medical Center University Campus, the local district attorney’s (DA) office and the Pima County Jail. Sierra Tucson offers a range of treatment modalities and exposure to psychopathology unavailable in other behavioral health spaces, she says. The facility also caters to a different socioeconomic class of patients and offers an integrated, holisitic approach, so student residents would be exposed to a different sort of learning experience at Sierra Tucson.

“Residents are able to see people in county facilities on inpatient, acute psychiatric units, but the types of psychopathology that we see [here] are completely different,” adds Genovese.

For example, at Sierra Tucson, patients fall under six treatment categories—general psychology, mood disorder, eating disorders, chemical dependency, trauma, and chronic or complex pain—and admit themselves on a voluntary basis. Various treatment options are offered, including acupuncture, Reiki and equine therapy, as well as different types of pharmacology and psychotherapy.

Although the university is not ready to make Sierra Tucson a site residency requirement, Kaempf says the goal is to actively encourage residents to take advantage of the experience to work there.

Six areas of care

Interested fourth-year residents will be pre-screened by Sierra Tucson and will be provided an individual curriculum appropriate for their area of focus. Additionally, students will have the option of participating in a more general program where they rotate through all six areas of care, or the ability to focus on one specific discipline. This would be decided upon by Genovese, the resident director and the resident.

Throughout the rotation program, residents will be immersed in meetings and interactions alongside Sierra Tucson staff and will receive guidance from Genovese. He says Sierra Tucson hopes to take in several residents at a time. Depending on interest level, he anticipates around four to six rotation participants at one time between both programs.

Eventually, Genovese hopes to expand the rotation site to include residents’ medical students, so that the residents not only have the opportunity to learn from attendings but also to be teachers in the setting.   

Kaempf says that UofA medical students work primarily at Tucson hospitals and the DA's office, where they deal with seriously mentally ill patients. She says that an expansion of the rotation program at Sierra Tucson to include medical students would expose them to  an area of treatment they wouldn’t otherwise see.

”My hope would be if medical students gain exposure to a wider variety of mental health experiences, we could hopefully turn more medical students on to wanting to [pursue] psychiatry,” she says.